What Causes a Migraine?

For many years it was believed dilation of the blood vessels in the head was to blame.

This is called the vascular theory of migraine.

Blood vessels appear to contract and then suddenly dilate, increasing blood flow to the head.

The blood vessels are attached to nerve fibres and the widening of the blood vessels results in pressure pain. In contrast, a regular headache is usually caused by constriction of the same blood vessels.

It’s now believed the dilation of the blood vessels is an effect rather than the cause, and other factors cause the change in blood vessel diameter.

It appears the most likely cause is neurological. Some scientists believe stress or muscular tension causes the initial narrowing of the arteries.

We have a nerve called the trigeminal nerve which is responsible for sensation in the face, particularly pain perception around the eyes and head.

Messages travelling along this nerve cause blood vessels around the brain to expand.

The trigeminal nerve appears to become activated in migraine sufferers for reasons unknown, causing pain symptoms in any part of the face and head.

Inflammation of the tissue surrounding the brain can also contribute to the symptoms of migraine.

Nitric oxide is a chemical naturally produced by the body which regulates the muscles in our veins as well as the circulation of blood to the head.

It’s believed if we produce too much nitric oxide this will cause our cranial blood vessels to dilate and may precipitate a migraine.

Migraine Treatment

In the past, it was thought migraines were treated by a horrific process known as trepanning, which involved drilling a hole into a person’s skull to release evil spirits.

Anyone who has ever experienced the extreme pain of a migraine can imagine the lengths people may have been willing to go for a cure in the days before painkillers.

Nowadays, pain-relieving medications can be taken during an attack or preventative medicine is often prescribed to reduce the likelihood of attacks which often act on the blood vessels in the head. However, many of these medications come with side effects.

Chocolate has been found to be positively correlated with migraine. (2)

Cheese. A substance which naturally occurs in many cheeses, called tyramine, can trigger migraines. Tyramine is especially high in aged cheese, blue cheese, strong cheddars, swiss cheese and parmesan. Tyramine is also found in smoked fish and cured meats such as salami. Tyramine is naturally broken down in the body by a specific enzyme. If we don’t have enough of this enzyme, tyramine levels can remain high and spark off a migraine.

Nitrates, found in bacon, deli meats, sausages and hot dogs, can trigger migraines. Added to this, cured meats will also contain tyramine for a double migraine-provoking effect. Researchers believe bacteria in our mouth can convert nitrates to nitrites, which then boosts levels of blood vessel dilating nitric oxide. In fact, one study (3) found migraine sufferers have more of these bacteria than people who aren’t affected. It’s likely they make more nitric oxide when they eat foods containing nitrates.

Caffeine. The role of caffeine in migraine is contradictory. On the one hand small amounts of caffeine can relieve a migraine(4), but if caffeine is stopped abruptly, a rebound migraine may occur. If you’re looking to quit caffeine, reduce your intake slowly, by about 25% a week to avoid these. Remember many over-the-counter headache remedies contain caffeine.

Mono-sodium glutamate (MSG). This food additive is used as a flavour enhancer, particularly in Chinese food. It’s a common culprit for triggering migraines.

Pickled foods such as kimchi, sauerkraut, pickled vegetables and kombucha. These can also contain high levels of tyramine.

Chemicals such as phenylalanine, a naturally occurring amino acid found in dairy products, soya, pumpkin seeds, meat, fish and eggs, and the artificial sweetener aspartame may be culprits. Some people find citrus fruits, bananas, nuts or even beans can trigger an attack.

One study saw a 24% reduction (11) in the average number and severity of attacks.

Although some other studies have been inconclusive, another study (12) enrolled volunteers who already used feverfew as a migraine prevention strategy and gave half of them a placebo without their knowledge.

Those receiving the placebo saw a significant increase in the frequency and severity of their headaches, nausea and vomiting.

Lavender

Inhalation of essential oil of lavender (13) for 15 minutes was found to significantly reduce the severity of a migraine. Alternatively, try applying lavender oil to your temples.

Co-Enzyme Q10

This is a nutrient often described as a ‘vitamin-like substance’. Co-Enzyme Q10 is known to be involved in the creation of ATP, which is used as the major energy source of our cells.

In one study, (14) migraine sufferers were given 150mg co-enzyme Q10 a day.

Over 60% of the participants experienced more than a 50% reduction in the number of days they suffered from a migraine. The duration of their pain also reduced.